I have often wondered what it feels like to be a patient in the hospital. My personal experiences as a patient have been limited to the occasional clinic visit, having my wisdom teeth removed and a brief visit to the ED when I was 17, after cutting my foot open while backpacking in Point Reyes. For all intents and purposes I stay securely and safely on the provider side of things. We get to keep our clothes on, we can for the most part eat what we like, drink what we like and unless you happen to be retracting in the OR for hours on end, we can use the bathroom when we want to. Sure it can be a little uncomfortable and down right exhausting to be working in the hospital taking care of patients. I’ve started to refer to all the walking and rounding and standing we do as ‘slogging in my clogs,’ and I know you know the feeling. But when it comes to actually being a patient, no less one who is acutely ill, we don’t know the feeling—at least not most of us anyway. So we are left to imagine what it might be like.
The other day I was helping an intern pack a horrendous and impossibly deep abscess and as we pulled miles of blood soaked curlex out the wound I got to wondering what that must feel like. Vomit started to well up in the back of my mouth. I don’t really want to be sick or hurt. Because who the hell does? But I do want to understand just a little bit better the loss of control patients must feel, the fear, the embarrassment and the sleepless noisy nights and rude early morning wake up calls. Back in the day it used to be a fairly common practice to admit medical students to the hospital under a pseudonym and a fake (albeit mild) diagnosis, in order to allow them to experience the hospital as a patient. The Long Beach Medical Center still has a program like this—the only one left in the country started by an Australian Family Medicine physician, Dr. Stephen Brunton. You can read more about that program here. http://articles.latimes.com/1988-07-05/news/vw-5362_1_hospital-patient
Programs like this one are insanely difficult to do. Hospital resources are stretched so thin these days, they aren’t about to waste them just so trainees can try on a hospital gown for the evening. But I maintain that the lessons the participants learn from a brief time in the hospital is immensely valuable. And if hospitals care about patient satisfaction the way they claim, then I’d like to see programs like this become common place. So I started sending emails out to hospital CEOs and CMOs, ER directors and the like, asking If I could spend a night in their hospital. The answer was a swift and resounding absolutely not. Even the task of having the IT department create a fake EMR for me was too great a task for most hospitals to manage. Additionally, I think that hospitals also feared that real harm might come to me. And perhaps they are right to be concerned, after all medical mistakes result in thousands of deaths across the country each year. http://www.healthcareitnews.com/news/deaths-by-medical-mistakes-hit-records
For now, I have been attempting to experience patient life in other ways. For one, I tried patient coffee the other day. No—not the coffee in the cafeteria, but the brown liquid served up in miniscule Styrofoam cups. I don’t know what it was, but it sure as hell wasn’t coffee. I also let my friend Millie put me in an MRI machine for two and half hours to study my brain for her PhD. It was okay I guess, a little loud for my liking, but at least now I have confirmation that my headache isn’t a brain tumor. And finally, I am feebly attempting to live my life as a diabetic—a diagnosis I do not really have. I have tried to write down my carbs and test my blood sugar, but after bleeding like a stuck pig all over our kitchen after repeatedly stabbing my finger with a lancet I am taking a bit of a break. Because being diabetic sucks and I can’t do it.
I hope you never actually get to be a patient in the hospital. And unless we are actually facing illness or injury our experience will always be limited. But let’s challenge ourselves to experience more of what it might be like. Try laying on one of the gurneys to see how it feels. Let someone practice starting an IV on you so you can know how badly it hurts. Try on a Philadelphia collar (literally the more uncomfortable neck brace ever). And if in doubt about where to start to get to know hospital life, talk to your patients, ask them more, drink the coffee—I dare you.